Provider Demographics
NPI:1215961875
Name:WHITE, RENEE CARRIE (RN)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:CARRIE
Last Name:WHITE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 E 200TH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44119-2391
Mailing Address - Country:US
Mailing Address - Phone:216-531-5280
Mailing Address - Fax:216-531-5483
Practice Address - Street 1:580 E 200TH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44119-2391
Practice Address - Country:US
Practice Address - Phone:216-531-5280
Practice Address - Fax:216-531-5483
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-255089251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health